Student Applicant        

Name of Person Completing Reference          
             
Phone Number       

Address                 

City, State, Zip        

Country                  

E-mail Address       

Profession/Position:

Please answer the following questions:

1. How long have you known the applicant? In what capacity?

2. Describe the applicant’s experience with community involvement, family responsibilities, service and/or work. Also comment on applicant's ability and willingness to build community among peers.


3. Bonner first years tutor students in local primary schools.  Timely communication is critical in maintaining harmonious relationships with our educational partners. Comment on the applicant's level of dependability, initiative, ability to work with minimal supervision and leadership potential.

4. Bonners serve and communicate with people of various ages, cultural, economic, educational, racial, and religious backgrounds. Please comment on the applicant's relationships with others and ability to work as part of a team.  

5. Comment on the applicant's flexibility and their ability to adapt and work under difficult and changing conditions.  

Please rank the applicant's following qualities on a scale of 0-4
Unable to Judge=0        Below Average-1        Average=2      Above Average=3        Excellent=4

Ability to accept direction in work 0 1 2 3 4              Ability to work independently 0 1 2 3 4
Ability to work with others 0 1 2 3 4                         Follow through with responsibilities 0 1 2 3 4
Behavior in difficult situations 0 1 2 3 4                   Communication skills 0 1 2 3 4
Integrity 0 1 2 3 4                                                    Creativity 0 1 2 3 4
Leadership 0 1 2 3 4                                               Reliability 0 1 2 3 4
Responsibility 0 1 2 3 4                                           Time management 0 1 2 3 4
Flexibility 0 1 2 3 4                                                  Respect for others 0 1 2 3 4
Initiative 0 1 2 3 4                                                   Knows his/her limits 0 1 2 3 4
Cares for her/his needs 0 1 2 3 4                          Maturity 0 1 2 3 4
Tact 0 1 2 3 4                                                         Overall, how would you rate the applicant 0 1 2 3 4

6. Are there additional comments you would like to make? Please use this space to expand on or explain your ratings. Explain any reservations that you have regarding the applicant's participation in the Bonner Program. 

Please chose one statement for your overall recommendation.

I recommend this student without reservation.
I recommend this student with reservation (explained above).
I do not recommend this student.

Applications and recommendations must be received by midnight CST Thursday, June 27, 2013.